Submandibular lymph nodes: location, principles of functioning and altered states

What is submandibular lymphadenitis

Submandibular lymphadenitis is an inflammatory disease of the submandibular lymph nodes, which can take an acute and chronic course. Lymphadenitis of the submandibular lymph nodes is very often odontogenic (when the infection spreads from periodontal tissues (apical or marginal periodontitis), with pericoronaritis of the lower wisdom teeth, with suppuration of a radicular cyst, alveolitis). Also, the cause of an inflammatory process in the lymph node can be an infection in the tonsils, ear, throat and oral mucosa. Acute lymphadenitis can occur in serous and purulent forms.

General information

The organs of the lymphatic system play a protective role in the human body. They serve as a barrier to viruses, bacteria, and also filter out harmful substances. In total, there are more than 450 lymph nodes in the adult body, and their maximum number is formed by the age of 10.

Lymph nodes are connected by lymphatic vessels - lymph (a fluid with a high content of lymphocytes, or “white blood cells”) circulates through them. Produced in the bone marrow, lymphocytes circulate throughout the body, first passing through the spleen and then the lymph nodes. Thanks to this, they gain the ability to produce antibodies to destroy microbes. Source: A.G. Rumyantsev, professor, V.M. Chernov, professor, V.M. Delyagin, professor Enlarged lymph node syndrome as a pediatric problem Practical Medicine, 2007, No. 5 (24), pp. 12-15

When an infection enters , a kind of “attack” is carried out on it, as a result of which the lymph nodes can enlarge (during this period they more actively produce antibodies). After recovery, the nodes return to normal size. If their diameter and density do not return to their original state, the child must be shown to a doctor.

Features of enlarged mental nodes in various pathologies

The proliferation of lymphoid tissue under the chin is local or generalized. In the first case, the immune links of only one anatomical region become larger, in the second - those located in other places (for example, with HIV infection, diseases of the genitourinary system, syphilis, mumps, etc.).

Caries often causes chronic enlargement of formations. If the mental lymph node hurts and has become larger on one side, this means that the pathological focus is localized near the affected area. This occurs with skin trauma, as well as bacterial infections and diseases of the oral cavity.

In rare cases, the enlargement of the lymph node under the chin is due to a tumor process. In this case, inflammation occurs in the submandibular bone, and the formation changes its characteristics. This condition indicates the penetration of metastases into the immune system from other organs.

Indicators of normal lymph nodes:

• diameter up to approximately 5 mm;
• soft consistency;
• single location, that is, lack of connection with each other or with the skin;
• absence of pain upon palpation (palpation);
• mobility.

Reasons for enlargement and main groups of lymph nodes

Function of the lymphatic system

The lymphatic system works closely with the circulatory system. With the help of a network of capillaries, vessels and nodes of the lymphatic system, various substances that are not able to penetrate the walls of blood vessels enter the blood.

So, before new particles enter the bloodstream, they are “tested” by the lymphatic system. If a certain element turns out to be potentially dangerous, it will be attacked by lymphocytes.

This filtration occurs precisely in the lymph nodes, where particles are brought with the lymph flow from the surrounding tissues. There are several types of lymphocytes in the human body and they all perform their function in protecting the body.

Lymph nodes are located in groups. They take on the task of protecting nearby tissues and organs.

What are the submandibular lymph nodes responsible for?

Lymph nodes on the lower jaw collect fluid from the intercellular space of nearby tissues and filter it. All infections that enter them are destroyed, provided that the person’s immune system works adequately. Cell waste products and decay products are also filtered out.

Important: one of the important tasks of the lymph nodes is the fight against cancer cells.

In the lymph nodes, new lymphocytes are produced and matured, which will fight infection in this area. Also in the lymphatic system of this area, harmful substances circulate from the blood to the lymph, and beneficial and nutrients are transferred from the lymph to the blood.

The correct functioning of the nodes in the lower part of the face is very important, because they have to deal with common diseases.

The most common diseases that lymphocytes of the submandibular space have to fight:

Important: submandibular nodes can become inflamed as an independent phenomenon, without a primary extraneous factor.

Location of submandibular nodes

Submandibular lymph nodes, location and proximity to other lymph nodes

Lymph nodes on the jaw, that is, local formations of lymphatic tissue, are located along the path of the vessels of the lymphatic system, parallel to the course of the blood vessels. There are six to eight lymph nodes in the submandibular space.

They are located in a triangular zone under the lower jaw, slightly in front of the salivary gland, as well as in the thickness of its tissue. Lymph nodes surround the facial vein, located in front and behind it.

Vessels with lymph tend to the node from the following parts of the face:

• from the skin of the upper and lower lips;
• from the neck;
• from the chin and cheeks;
• from the outer part of the nose and its internal space;
• from the inner surface of the lower eyelid;
• from teeth, gums and palate;
• from the tongue and sublingual space;
• from all salivary glands;
• from the submandibular lymph nodes.

The video in this article and photos will clearly demonstrate which lymph nodes are responsible for which organs and tissues of the human body.

External features of nodes

Diagram of the structure of a lymph node

The lymph node in the jaw is a bean-shaped collection of lymphatic tissue. The nodes have different sizes.

In normal condition, the node has the following characteristics:

• it is soft to the touch;
• does not cause pain when touched;
• a normal size does not prevent the head from lowering to the chest, and the nodes are not felt;
• visually, the submandibular lymph nodes are not visible under the skin.

The lymphatic tissue itself is pink-gray in color. The nodes are arranged in groups and covered with a protective capsule of connective tissue.

Important: in the absence of acute inflammation in the surrounding tissues, only one, the largest submandibular node can be felt.

Lymph enters the node through incoming vessels - the gate, which is a hole on the upper part of the protective capsule. Along with the lymph flow, nerve fibers enter the node. Purified lymph exits through the efferent vessels.

The entrance and exit of lymph are arranged in such a way that each node includes 2-4 vessels, and at the exit there are only 1-2 vessels, and their diameter is larger than that of the incoming ones. The inner part of the node is equipped with parenchyma, a loose connective tissue layer in which lymphocytes of various types are based.

Oncological alertness

Lymph nodes are often enlarged due to lymphogranulomatosis (Hodgkin's lymphoma) or lymphosarcoma (non-Hodgkin's lymphoma). These are malignant processes that are manifested by increased density, painlessness and large diameter of the lymph nodes in the absence of other reasons for their deformation. Lymph nodes enlarge in groups, asymmetrically (for example, on one side of the neck). At the initial stage of the process, their mobility and separate arrangement are maintained. If the oncological process continues without treatment, the lymph nodes may become fused, and moderate pain rarely occurs. Source: N.V. Nagornaya, E.V. Vilchevskaya, A.P. Luachak, E.N. Marchenko, E.V. Bordyugova, A.P. Koval Hodgkin's disease (lymphogranulomatosis) in children // Child's Health, 2013, No. 1 (44), pp. 13-15

Symptoms that require consultation with a doctor are enlarged lymph nodes:

• more than 7 days;
• more than 1 group;
• accompanied by elevated body temperature;
• in a child under one year old;
• progressive over time;
• with changes in local skin.

Causes

Teething may be the cause of nonspecific submandibular lymphadenitis in a child

Submandibular lymphadenitis in children is caused by the fact that lymph nodes up to 10 years of age are involved in almost all inflammatory processes, since they are one of the links in protective mechanisms.

They are extremely sensitive to:

• any foreign elements in the body;
• bacteria or viruses;
• toxic substances;
• particles that form during the breakdown of tissues or cells.

This happens due to the fact that the lymph nodes capture these elements, preventing their spread through the blood and lymphatic channels. As a rule, lymphadenitis occurs for nonspecific reasons, for example, the spread of pathogenic microflora, often various cocci. In this case, the infection enters the blood from the main source, which leads to enlargement and pain of the lymph nodes.

Important. About 70% of submandibular lymphadenitis in childhood is caused by otorhinolaryngological diseases: tonsillitis, sinusitis and otitis media.

At the age of 6-7 years, inflammation of the lymph nodes is often associated with dental pathologies (pulpitis, periodontitis, osteomyelitis), and discomfort often occurs after the primary lesion has subsided.

Other causes of lymphadenitis:

• teething;
• skin infections;
• infectious diseases of any nature and origin (influenza, scarlet fever, measles, ARVI and others);
• leukemia;
• oncological diseases;
• chronic diseases of the gastrointestinal tract;
• lymphatic-hypoplastic diathesis;
• herpes virus infections.

The note. If the lymph nodes are mechanically injured, they can become inflamed.

Specific lymphadenitis is caused by:

• tuberculosis;
• syphilis;
• mononucleosis of infectious nature;
• actinomycosis;
• brucellosis and others.

Diagnostic methods

After examination and collection of complaints and medical history, the specialist sends the child for a general examination . It includes x-rays, blood and urine tests . Additionally, the following studies may be needed:

• blood serology;
• diagnosis of tuberculosis;
• lymph node biopsy followed by cytological examination in the laboratory;
• Ultrasound.

Sometimes children are prescribed antibacterial drugs as part of the diagnosis. Based on their effectiveness, they confirm or refute the bacterial nature of the disease.

Treatment methods

Enlarged lymph nodes are not an independent disease, but a symptom of some other disease. Therefore, therapy in this case comes down to eliminating the root cause of this reaction. The rate at which nodes return to normal size varies, depending on the severity and type of underlying disease.

If a child gets sick very often, then immunomodulators are recommended to strengthen the body's defenses. The choice of drug should be made only by a doctor.

Important! Enlarged lymph nodes should not be heated - this can lead to the development of suppuration and blood poisoning! Any self-medication is prohibited - the reason and type of therapy is determined by a specialist.

What not to do if the chin lymph nodes are enlarged

Having discovered a pathology, you need to consult a specialist. Self-medication can only aggravate the situation or blur the true picture of the disease. This is especially true for the use of antibiotics at your own discretion. In some cases, drugs may be useless and even harmful. In addition, it is prohibited:

• warm the affected formations;
• apply cold compresses;
• unauthorized use of painkillers.

Most often, enlarged lymph nodes under the chin are observed in diseases of the oral cavity and ENT organs. The pathology disappears after the cause of its appearance is eliminated. If this does not happen, then additional consultation with a doctor is required.

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If your child has enlarged lymph nodes in the neck or in any other area, you should urgently contact a specialist for diagnosis and treatment. Delay in some cases is very dangerous!

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Sources:

1. A.G. Rumyantsev, professor, V.M. Chernov, professor, V.M. Delyagin, professor. Syndrome of enlarged lymph nodes as a pediatric problem // Practical Medicine, 2007, No. 5 (24), pp. 12-15.
2. N.V. Nagornaya, E.V. Vilchevskaya, A.P. Luachak, E.N. Marchenko, E.V. Bordyugova, A.P. Koval. Hodgkin's disease (lymphogranulomatosis) in children // Child's Health, 2013, No. 1 (44), pp. 13-15.

Grek Elena Anatolyevna Clinic

Author of the article

Grek Elena Anatolyevna

Doctor of the highest qualification category

Specialty: immunologist

Experience: 23 years

The information in this article is provided for reference purposes and does not replace advice from a qualified professional. Don't self-medicate! At the first signs of illness, you should consult a doctor.

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